© P o l s k i e T o w a r z y s t w o G i n e k o l o g i c z n e Nr 09/2013
754
P R A C E O R Y G I N A L N E ginekologia
+MRIOSP4SP
Estimated breast cancer risk and screening outcomes among premenopausal women with non-cyclic mastalgia
Szacowane ryzyko raka sutka oraz wyniki badań skriningowych u przedmenopauzalnych kobiet z niecykliczną mastalgią
/HFK5RJXOVNL-DQ%LĔF]\N
“Medyk-Centrum” Private Medical Center, Gynecology and Breast Diseases Clinic, Czestochowa, Poland
Abstract
Objectives: Breast pain is a common but worrisome symptom, which can cause a significant psychological bur- den of cancer stress. It is not known whether breast cancer risk estimation models can be used as an adjunct to the clinical and radiological assessment in counseling women with mastalgia. The aim of our study was to compare the estimated breast cancer risk and screening outcomes between patients with mastalgia and women requesting prophylactic examinations.
Material and methods: 112 premenopausal women with non-cyclic breast pain and 182 control women who presented for prophylactic examination were screened with mammography and ultrasound. Breast cancer risk esti- mated with the Gail and Tyrer-Cuzick models along with screening outcomes were compared between the groups.
Results: Premenopausal patients with mastalgia had lower estimated breast cancer risk than controls. The dif- ference was observed with both the Gail and Tyrer-Cuzick models (Gail 5-year risk: 0.66 ± 0.4% vs. 0.77 ± 0.4%, p=0.0002; Tyrer-Cuzick 5-year risk: 0.85 ± 0.4% vs. 0.95 ± 0.3%, p=0.002; Gail lifetime risk: 8.98 ± 3.6% vs. 9.6 ± 3.9%, p=0.015; Tyrer-Cuzick lifetime risk: 8.3 ± 3.1 % vs. 8.9 ± 2.7 %, p=0.045). Radiological and clinical outcomes were comparable between the groups.
Conclusions: Breast pain was associated with lower estimated breast cancer risk but had no effect on screening outcomes in the study population.
Keywords: breast cancer / breast pain / risk assessment / statistical models /
Otrzymano: 05.11.2012
Zaakceptowano do druku: 10.06.2013 Adres do korespondencji:
Lech Rogulski
“Medyk-Centrum” Private Medical Center, Gynecology and Breast Diseases Clinic, Czestochowa, Poland, 42-200 Czestochowa, al. Wolności 34
tel. +48 34 654666; fax.: +48 34 3683430 e-mail: lech.rogulski@gmail.com
© P o l s k i e T o w a r z y s t w o G i n e k o l o g i c z n e
Nr 09/2013
755
P R A C E O R Y G I N A L N E ginekologia +MRIOSP4SP
Lech Rogulski, Jan Bińczyk. Estimated breast cancer risk and screening outcomes among premenopausal women with non-cyclic mastalgia.
Introduction
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Streszczenie
Cel pracy: Ból sutków jest częstym, lecz niepokojącym dla kobiety objawem, mogącym powodować lęk o jego potencjalnie nowotworowe przyczyny. Przy klinicznej i radiologicznej ocenie kobiet z mastalgią nie stosowano do tej pory analizy ryzyka raka sutka przy wykorzystaniu modeli statystycznych. Celem naszej pracy było porównanie szacowanego ryzyka raka sutka oraz wyników badań obrazowych pomiędzy pacjentkami z mastalgią a kobietami zgłaszającymi się w celu przeprowadzenia badań profilaktycznych sutków.
Materiał i metody: 112 przedmenopauzalnych pacjentek z niecyklicznym bólem sutków oraz 182 kobiety zgła- szające się do badania profilaktycznego poddano mammografii oraz ultrasonografii sutków. Porównano pomiędzy grupami ryzyko zachorowania na raka sutka oszacowane przy użyciu modelu Gail’a oraz Tyrer-Cuzick’a jak również wyniki badań skriningowych.
Wyniki: Przedmenopauzalne pacjentki z mastalgią miały niższe szacowane ryzyko zachorowania na raka sutka w porównaniu z grupą kontrolną. Różnice obserwowano zarówno dla modelu Gail’a jak i Tyrer-Cuzick’a (5-letnie ryzyko wg Gail’a 0.66 ± 0.4% vs. 0.77 ± 0.4%, p=0.0002; 5-letnie ryzyko wg Tyrer-Cuzick’a: 0.85 ± 0.4% vs. 0.95
± 0.3%, p=0.002; całkowite ryzyko wg Gail’a: 8.98 ± 3.6% vs. 9.6 ± 3.9%, p=0.015; całkowite ryzyko wg Tyrer-Cu- zick’a: 8.3 ± 3.1 % vs. 8.9 ± 2.7 %, p=0.045). Wyniki kliniczne i radiologiczne nie różniły się istotnie.
Wnioski: Ból sutków był związany z niższym szacowanym ryzykiem raka sutka, lecz nie miał wpływu na wyniki badań skriningowych w badanej populacji.
Słowa kluczowe: rak sutka / ból sutka / ocena ryzyka / modele statystyczne /
© P o l s k i e T o w a r z y s t w o G i n e k o l o g i c z n e Nr 09/2013
756
P R A C E O R Y G I N A L N E
ginekologia +MRIOSP4SP
Lech Rogulski, Jan Bińczyk. Estimated breast cancer risk and screening outcomes among premenopausal women with non-cyclic mastalgia.
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Table I. Study results.
Mastalgia Prophylactic P
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Estimated breast cancer risk:
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© P o l s k i e T o w a r z y s t w o G i n e k o l o g i c z n e
Nr 09/2013
757
P R A C E O R Y G I N A L N E ginekologia +MRIOSP4SP
Lech Rogulski, Jan Bińczyk. Estimated breast cancer risk and screening outcomes among premenopausal women with non-cyclic mastalgia.
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Conclusions
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Conflict of interest statement
The authors declare that they have no conflict of interest.
Ethical approval
The study was approved by the bioethical committee of the Polish Mother's Memorial Institute in Lodz, Poland in February, 2009.
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